Provider Demographics
NPI:1144928334
Name:ZESATI, JOSE LUIS JR
Entity type:Individual
Prefix:MR
First Name:JOSE
Middle Name:LUIS
Last Name:ZESATI
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 N ELM ST
Mailing Address - Street 2:
Mailing Address - City:GRANDVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98930-1009
Mailing Address - Country:US
Mailing Address - Phone:509-840-7455
Mailing Address - Fax:
Practice Address - Street 1:106 N ELM ST
Practice Address - Street 2:
Practice Address - City:GRANDVIEW
Practice Address - State:WA
Practice Address - Zip Code:98930-1009
Practice Address - Country:US
Practice Address - Phone:509-840-7455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1801405642Medicaid